Objective To investigate the method and effectiveness of V-U-shaped flaps in repairing soft tissue defect of the fingertip. Methods Between January 2006 and February 2011, 47 patients (55 fingers) with soft tissue defect of fingertip were treated by using the V-U-shaped flaps. There were 25 males and 22 females, aged 18 to 35 years (mean, 26 years). The injury was caused by cuts in 21 cases and avulsion in 26 cases. The time between injury and admission was 1 to 6hours with an average of 2.6 hours. The injured fingers included thumb (18 fingers), index finger (10 fingers), middle finger (10 fingers), ring finger (9 fingers), and l ittle finger (8 fingers). Forty-one fingers had skin avulsion of the distal interphalangeal joint with phalanx exposure, and 14 fingers had distal dactylopodite defect and second phalanx exposure. The size of wound ranged from 1.1 cm × 1.0 cm to 1.9 cm × 1.7 cm. The time between injury and first-stage operation was 2 to 7 hours with an average of 5 hours. In the first-stage operation, the pedicled flap was used to repair the defect of dactylopodite. Then at 3 weeks after the first-stage operation, one U-shaped flap and two V-shaped flaps were prepared to cover defect of the fingertips in the second-stage operation. Results At 2 days after the second-stage operation, congestion and bl isters occurred in 5 fingers, and were improved after symptomatic treatment. The other flaps survived, and wounds healed by first intention. Incisions at the donor site healed primarily. After the second-stage operation, 42 cases (50 fingers) were followed up 6 to 12 months (mean, 8.9 months). The appearance, texture, and color of the flaps were similar to normal skin. Injured fingers had tactile, pain, and thalposis, and the two point discrimination was 5-8 mm. At last follow-up, according to the functional assessment standards by the Chinese Medical Association Society of Hand Surgery of the upper l imbs, the results were excellent in 46 fingers and good in 4 fingers. Conclusion V-U-shaped flaps can be considered as an ideal method to repair soft tissue defect of the fingertip because of good appearance and function recovery.
OBJECTIVE To evaluate the clinical efficacy of thin flap with subdermal vascular network of the neck-pectoral region on repair of the contracture of the burn scar on the neck. METHODS From March 1990 to May 1998, 21 cases of deformity of neck due to burn scar were repaired with the thin flap ranging from 8 cm x 5 cm to 14 cm x 8 cm, and all of the cases were followed up for 6 to 42 months. RESULTS Except partial necrosis of the distal end of the flap in 1 case, the flaps in the other 20 cases all survived and presented a satisfactory appearance and function. CONCLUSION The thin flap with subdermal vascular network in neck-pectoral region may provide a large area of flap, and could be easily transferred. It’s an ideal flap for the repair of skin defect on the neck.
Objective To review the historical origin and development of thin flap and flap thinning technique. Methods A wide range of domestic and foreign literatures on thin flaps and flap thinning technique were reviewed. The background, definition, methods, problems, challenges, and future development of thin flap and flap thinning technique were summarized and analysed. Results Thin flap and flap thinning technique play an important role in the development of flap surgery, leading flap surgery towards a more rational and refined direction. Conclusion Thin flap and flap thinning technique are still hot topics in the future. With the development of thin flap and flap thinning technique, clinicians will have more " free” choices.